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Intensive Care Medicine
Published in: Intensive Care Medicine 7/2005

01-07-2005 | Pediatric Original

A pilot study of inhaled nitric oxide in preterm infants treated with nasal continuous positive airway pressure for respiratory distress syndrome

Authors: Robert Lindwall, Mats Blennow, Mats Svensson, Baldvin Jonsson, Eva Berggren-Boström, Martino Flanby, Per-Arne Lönnqvist, Claes Frostell, Mikael Norman

Published in: Intensive Care Medicine | Issue 7/2005

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Abstract

Objective

To explore the acute effects of inhaled nitric oxide (iNO) on oxygenation, respiratory rate, and CO2 levels in spontaneously breathing preterm infants treated with nasal continuous positive airway pressure (nCPAP) for moderate respiratory distress syndrome (RDS).

Design and setting

Randomized, prospective, double-blind, cross-over study in the neonatal intensive care units of a university hospital.

Patients

15 infants treated for RDS, with a median gestational age of 32 weeks (27–36), birth weight 1940 g (1100–4125), and postnatal age at the beginning of study 23 h (3–91). nCPAP pressure was kept constant at 4.3 cmH2O (3.4–5.1).

Interventions

We examined effects on gas exchange and vital signs during a 30-min exposure to 10 ppm iNO or placebo gas (nitrogen).

Results

Before administering test gases the baseline arterial to alveolar oxygen tension ratio (aAPO2) was 0.19±0.06. aAPO2 remained unchanged during placebo but increased to 0.22±0.05 (+20%) during iNO exposure. Respiratory rate and arterial carbon dioxide tension remained unchanged, as did heart rate, blood pressure, and methemoglobin. Follow-up at 30 days of age showed no deaths, delayed morbidity, or need for supplemental oxygen.

Conclusions

Adding 10 ppm nitric oxide to nasal CPAP treatment in preterm infants suffering from RDS results in a moderate but statistically significant improvement in oxygenation, with no effect on respiratory drive or systemic circulatory parameters.
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Metadata
Title
A pilot study of inhaled nitric oxide in preterm infants treated with nasal continuous positive airway pressure for respiratory distress syndrome
Authors
Robert Lindwall
Mats Blennow
Mats Svensson
Baldvin Jonsson
Eva Berggren-Boström
Martino Flanby
Per-Arne Lönnqvist
Claes Frostell
Mikael Norman
Publication date
01-07-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 7/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2593-5

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